block 5 anatomy

Know the importance of the ligament of the head of the femur (aka acetabular ligament).

Provides more stability but less mobility. Transmits branches from the obturator artery that nourish femoral head.

Know which nerves are part of the lumbosacral plexus, including the roots.

Lumbar Plexus L1-L4
Iliohypogastric L1
Illiolingual L1
Centitofemoral L1-L2
Lat. Femoral cutanues L2-L3
Obutrator L2-L4
Femoral L2-4
Scral plexus L4-S4
Superior gluteal L4-S1
Inferior gluteal L5-S2
Posterior femoral cutaneuous S1-S3
Sciatic common fib L4-S2
Sciatic tibial L4-S3
Pudendal s2-s4

Psoas major location, origin and insertion, function, and innervation

Psoas miajor - originates T12-L4 intervertebral disk and L1-L5 for deep. Insertion is the lesser trochanter and innervated by lumbar plexus flexes and rotates hip joint plus bilateral contraction

Iliacus location, origin and insertion, function, and innervation

Illiacus-Origin is illiac fossa, inserted by lesser trochanter and innervated by femoral nerve.
rotates hip joint plus bilateral contraction

Gluteus maximus, location, origin and insertion, function, and innervation

Origin is from the sacrum, thoracolumbar fascica, sarcotuberous ligament and illieum. Insertion upper fibers Illiotibial tract, lower fibers gluteal tuberosity, innferior gluteal innervation, Entire muscle extended
Innervation is superior gluteal nerve

Gluteaus medias location, origin and insertion, function, and innervation

Origin: Ilium below iliac crest
Insertion: greater trochanter of the femur
Innervation is superior gluteal nerve
Action: Entire muscle abducts the hip, stabilizes the pelvis in coronal place, anterior part flexion and internal rotation. posterior part extension and external rotation

Gluteas minimus location, origin and insertion, function, and innervation

Origin: ilium below gluteus medias
insertion: greater trochanter of femur, innervated by superior gluteal and action is to Entire muscle abducts the hip, stabilizes the pelvis in coronal place, anterior part flexion and internal rotation. posterior part extension and external rotation

Tensor fascia latae location, origin and insertion, function, and innervation

Origin is anterior superior iliac spine, insertion is illiobial tract, innervated by superior gluteal nerve, action is to tense fasica lata, hip joint abduction, flexion and internal rotation

Piriformis location, origin and insertion, function, and innervation

Origin pelvic surface of the sacrum, Direct branches from sacral plexus innervation
Insertion apex of the greater trochanter of the femur
action is external rotation, abduction and extension of the hip joint, stabilized the hip part

Obturator internus location, origin and insertion, function, and innervation

Origin: Inner surface of the obturator membrane and it's boundaries
Insertion:Medial surface of greater trochanter
Innervation is sacral plexus
Action is external rotation, adduction and extension of the hip joint

Superior and inferior gemellus
location, origin and insertion, function, and innervation

superior is ischial spine and inferior is ischial tuberosity
insertion is joint with obturator intermus tendon and innervation is sacral plexus

Quadratus femoris location, origin and insertion, function, and innervation

Origin is lateral border of the ischial tuberosity
insertion is the intertrochanteric crest of the femur and innervation is the Sacral plexus

Sartorius

anterior superior iliac spine, and is inserted medially to the tibial tuberosity and is innervated by the peroneal nerve

Quadratus femoris- rectus femoris, vastus medialis, vastus lateralis, vastus intermedius

lateralis and medialis surround intermediate at linea aspera while intermediate stays at the frontal shaft all on tob op of the volcano, femoral nerve

Pectineus

origin is pectin pubis, inserted at the femur and is innervated by the opturator and femoral nerve

Adductor longus and brevis

Longus is superior to pubic ramus
Brevis, inserted at the femur

Gracilis

-Origin ischiopubic ramus

-Insertion tibia (pes anserinus)

-Nerve anterior branch of obturator nerve

-Actions flexes, medially rotates, and adducts the hip,

Obturator externus

Origin: Outer surface of inferior and superior rami of pubis, ramus of ischium

Insertion: Trochanteric fossa of femur

Action: Laterally rotates thigh

Innervation: obturator nerve (L3, L4)

Adductor minimus and magnus

minimus is origined at inferior pubic ramus and inserted st the deep part of the lines spine innervated by obturator

maximus is also at the pubic ramus and inserted at the superior part of the adductor tubercle
innervated by obturator and sciatic

Hamstrings- biceps femoris, semitendinosis, semimembranosis

all originate from the ischial tuberosity, innervated by tibial nerve

Triceps surae- gastrocnemius and soleus

gastro originates ate the femur
soleus originates at the fibula

both inserted by the calcaneal tuberosity and achilies tendon

innervated by tibial nerve

Plantaris

origin: lateral condyle of femur
insertion: calcaneal tuberosity
innervated by tibial nerve

Tibialis posterior

-Origin Tibia and fibula interosseous membrane

-Insertion: Navicular and medial cuneiform bone

-Nerve Tibial nerve

-flexes plantar

Flexor digitorum longus

Origin: Posterior surface of tibia

Insertion: Distal phalanges of toes 2-5
Action: Flexes toes; plantar flexes and inverts foot

tibial innervation

Flexor hallucis longus

origin: posterior surface of fibula

insertion: 1st digit

action: flexes 1st digit

innervation tibial

Popliteus

-Origin lateral femoral epicondyle

-Insertion posterior surface of tibia proximal to soleus line

-Nerve Tibial nerve

-Actions
=Medially rotates tibia on the femur if the femur is fixed (sitting down) or

= laterally rotates femur on the tibia if tibia is fixed (standing up),

=unlocks the knee to allow flexion (bending)

Tibialis anterior

Origin: lateral surface of tibia and interosseous membrane

Insertion: medial cuneiform and 1st metatarsal

innervation:deep fibular

Action: dorsiflexes and inverts foot

Extensor hallucis longus

-Origin Arises from the middle portion of the fibula on the anterior surface and the interosseous membrane

-Insertion Inserts on the dorsal side of the base of the distal phalanx of the big toe

-Nerve deep fibular nerve
deep peroneal nerve, L5 (L4-S1)

-Actions
=Extends the big toe and assists in dorsiflexion of the foot at the ankle.

-Antagonist Flexor hallucis longus, Flexor hallucis brevis

Extensor digitorum longus

-Origin Anterior lateral condyle of tibia, anterior shaft of fibula and superior 3⁄4 of interosseous membrane

-Insertion: Dorsal surface; middle and distal phalanges of lateral four digits

-Nerve deep fibular nerve

-Actions
=extension of toes
=dorsiflexion of ankle

-Antagonist Flexor digitorum longus, Flexor digitorum brevis

Fibularis tertius

Origin: Anterior surface of fibula

Insertion: Dorsal surface of fifth metatarsal

innervation: deep fibular

Action: Dorsiflexion and eversion of foot

Fibularis longus

origin: lateral surface of fibula

insertion: medial cuneiform and 1st metatarsal

innervation: superficial fibular

action: plantar flexes and everts foot

fibularis brevis

Origin: distal lateral border of fibula

Insertion: metatarsal V

innervation
superficial fibular

Action: plantarflexes and everts foot

Understand the angle of inclination

Biochemically favorable position for walking, abnormal angle increase stress on hip joint and impact gait

Know the Clinical significance of hip fracture and congenital dislocation of the hip

Hip fractures due to osteoporosis in the elderly; the fracture cause the person to fall

Hip dislocation; birth defect more common in females than males, acetabulum fails to form completely or the ligaments of the hip joint are loose.

Know the blood supply of the lower limb

Descending admoinal aorta, common iliac, internal and external illiac, external iliac to lower limb

venous drainage of the lower limb

Superficial venous drainage
have perforating branches connecting to deeper veins
dorsal venous arch on dorsum
drains to great and small saphenous veins
great saphenous vein
originates in medial ankle
extends adjacent to medial surface of entire lower limb
drains into femoral vein

Know the clinical significance of the popliteal and femoral arteries.

Femoral turns into popliteal. Anastheomosis and athrosclrosis
hunter and aductors canal

You can also popliteal to check blood pulse

Know the Clinical significance of the femoral triangle, including the borders and contents, and herniation.

Know the intrinsic and extrinsic ligaments of the knee

Know the names and location of all tarsals

Intrinsic Dorsum

Extensor digitorum brevis
Extensor hallucis brevis

Extensor digitorum brevis

Origin: dorsal surface of calcaneus

innervation: deep fibular nerve

Action: extends digits II-V

Extensor hallucis brevis

Origin: dorsal surface of calcaneus

Innervation: deep fibular

Action: extends digit I

Superficial Sole (1st Layer)

abductor hallucis, flexor digitorum brevis, abductor digiti minimi

Abductor hallucis

Origin: calcaneal tuberosity

Innervtaion :medial plantar

Action: abducts and flexes hallux

Flexor digitorum brevis

Origin: calcaneal tuberosity

innervation:medial plantar

Action: flexes digits II-V

Abductor digiti minimi

Origin:
Tuberosity of the calcaneous.
Plantar aponeurosis

Actions:
Abducts 5th toe
Innervation:

Lateral plantar nerve (S1, S2)

Deep Sole (2nd and 3rd Layers)

quadratus plantae, lumbricals, flexor hallucis brevis, adductor hallucis, flexor digiti minimi brevis, opponens digiti minimi

Quadratus plantae

Origin: calcaneus
Insertion: tendon of FDL

Innervation: lateral plantar

Action: augments the pull of flexor digitorum longus

Lumbricals

Origin: medial borders of digital branches of flexor digitorum longus tendon

innervation: 1st is medial planter, 2nd-4th is lateral plantar

Action: flexes metatarso-phalangeal joints and extends interphangeal joints of digits II-V; adducts digit V

Flexor hallucis brevis

Origin:
Cuboid
Lateral cuneiform

Flex proximal phalanx of great toe
Innervation:

innervation: Medial plantar nerve for medial and lateral plantar nerve for lateral

Adductor hallucis

Origin:
Oblique head - 2-4 metatarsal bones, sheath of peroneus longus tendon.
Transverse head- plantar metatarsophalangeal ligaments of 3,4,5.
Transverse metatarsal ligament.

Actions:
adducts great toe

Innervation: lateral plantar nerve (S1, S2)

Flexor digiti minimi brevis

Origin:5th metatarsal and long plantar ligament

Action: Flexion of 5th toes mtp

Innervation: lateral plantar

Opponens digiti minimi

origin long plantar ligament

Innervation lateral plantar nerve

pulls 5th metatrasal and medial direction

Deep Sole (4th Layer)

plantar interossei
dorsal interossei

Plantar interossei

Origin= medial surface of 3rd-5th metatarsals

Action= adduct 3rd-5th toes; flex 3rd-5th toes

Nerve= lateral plantar

Dorsal interossei

Origin 1-5 metatarsals

Nerve lateral plantar

Actions flexes and extends 2-4th toes
abducts 3-4 toes